| NPI | 1164884540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME154646) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 54689) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: KY 54689) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2022-09-07 |